i didn't post the article......someone did, i read it and i commented on it....as within my right of free speech in responce.....full stop......you are free to comment on the article too......but you choose to get personal as usual........

it has everything to do with msia, as a significant number of msian doctors still go through the mrcp pathway for postgraduate qualification......and many contemplating as an alternative to the masters......

including some medical students wanting to practice overseas........

medical students are supposed to be very clever people, those of you here who may be contemplating presenting for the mrcp, go figure individually how the findings of this study may impact on each of you individually when you consider doing the mrcp.......if you consider it of no impact, just ignore it......

that's how scientific evidence works......for most people at least.....

but for some.......will not accept.......

based on this warped logic, we will now have to say studies done in say, europe that drug x is useful for hypertension does NOT apply to msian patients, as it was done on european patients.........

all this just to suit an argumentative attitude......

same principles.......but this is an exercise in futility.....let readers judge for themselves......

opti, i think the relevance is not so much for those who are contemplating studying in uk, there are other ranking tables one can use.......

the variable is actually not the med schools, but the quality of students taken in.......and it is this aspect that may have a bearing on msians........a lot of msian doctors still take, or are going to take, the mrcp exams, as it is still recognised in msia as a specialist qualification......

as the study does show that there is a correlation between the quality of students and their chances of passing the exams, it can be a good benchmarking standard for msian trained doctors to assess their chances of success in the exams.......individually, they should know their innate ability.....

those who thinks it is of no relevance, can just ignore the study.......

why not?

you will have much more hands on experience than in big hospitals in the mainland.........

go talk to those who have gone there/still there.......the majority are quite happy........

there is 'supposed' to be a policy of 2 years MO before you are automatically eligible to be transferred back.......(if you include the housemanship, then it is 3 and nowadays, 4 years)...

but sometimes staffing is so short, they cannot release you, till replacements comes........and you get stuck longer.....

and sometimes people get so comfortable (ie, find someone special.....) they do not ask, so the state hq will just leave you there.......

there is also supposed to be a policy of giving people who have served their 'rural' postings in borneo (although one can hardly call it rural in the major cities) preferential consideration when applying for the masters programme.......but nobody knows if that it true, as there is little transparency in the process of selection......

i repeat what is have said many times.........

there are 6000+ students with straight a's.......dunno how many more with a b or two..........usually in non-core subjects like moral and est......

if you do NOT have say, at least 8a's in the core subjects, please do NOT consider medicine.......

of course one must do a proper pre-u before embarking on medicine......

but people can get into medicine WITHOUT pre-u......just go do a few months 'foundation', and you are in 1st year medicine.......think russia, and some indon places..........

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Added on March 13, 2009, 9:09 amand talking about different results in spm and pre-u.........

i know lots of people who did very well in spm (easy exam) but fare poorly in pre-u..........

but i do NOT know of anyone who did poorly in spm, and managed to score in any credible pre-u (ie stpm, a-levels, sam/ausmate).....

therefore again my statement........if you do NOT have good results in spm......don't consider doing medicine.......

This post has been edited by limeuu: Mar 13 2009, 09:09 AM

pmc has low academic cut-offs, and the 6 year programme is designed to allow people who are weak academically to 'try', as most here seem to want.......

do note that the irish qualification as awarded through pmc is NOT recognised by smc........

oh.........okay........that's a new development.......

i am not familiar with irish med schools, but they are generally easier to enter (apparently a lot of americans also go ireland for medicine too)........

it would not be possible for uk though, as the application process for sept 09 intake is well underway, and you have missed the qualification exams.........

that would be recognised by smc.........

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Added on March 13, 2009, 8:44 pm just for interest.........how bad was your spm, and how good was your credible pre-u?

This post has been edited by limeuu: Mar 13 2009, 08:44 PM

ucas is only for uk unis...........ireland is a completely different country.......

td mahathir graduated form the former uni of malaya, in spore........which now is the nus........(um as you all know it now only started off in 1959 as the uni of malaya in KL, ie kl campus, and formal separation into um and us in 1962.....the original med school, the king edward vii college of medicine was established in 1905 and continues to this day as the nus.....the um medical school started in 1964, and graduated the 1st batch in 1969).....he never earned any fellowship, his 'postgraduate' titles are all honorary......ie awarded as an honour.....

an a in spm means little, as it has been dumbed down too much.........hoards of people get straight a's (6k+).........

yes, irish med school fees are higher than uk......partly because of what happened to the pound and euro........

but it is more difficult to get into uk med schools, partly because of the exams and interviews.......and relatively easy into irish uni.........

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Added on March 14, 2009, 6:29 pmthe irish will be VERY upset you think they are part of the commonwealth.........try wiki the terse relationship between ireland and uk through history.........

americans who cannot get into their own med schools have traditionally gone to either the Caribbeans, ireland, or sometimes the Philippines......it doesn't matter where, as long as they get their usmle step 2, they can register and work........

This post has been edited by limeuu: Mar 14 2009, 06:29 PM

traditionally, medicine is taught based on subjects.......so the first part of the course will be pre-clinicals, and the basic medical sciences like anatomy, physiology, biochemistry, microbiology, pathology etc are taught as subjects......

this is a very dry way of learning, and students find it verd hard to find the relevance of what they study initially.....

over the last 20 years or so, there is a move towards an integrated system of teaching, based on organ systems.......where all the aspects of an organ system are taught together, and usually includes some patient exposure early on.........students find it much more interesting, with a better earlier understanding of the subject matter........

but the downside is a relatively shallow knowledge of the basic medical sciences, and gaps in the knowledge, as there are always parts of the basic sciences which does not fit into organ system, and students miss under the pbl (problem based learning) self studies.........

yes, imu uses the newer method, as do a lot of unis nowadays........

i would NOT say one is superior to the other, just that the integrated system makes it easier for the students, and the traditional system provides stronger foundation in the basic medical sciences........

i will have to plead ignorance about chinese medical education in general, overall superficial impressions is not favourable.......

let me do some research, and i will post some comments here later.......

okay, i have done some search, and these are my impressions, in general, and in particular to the several med schools mentioned.........

1. The quality of medical education is generally reflected in the country's quality of healthcare......students learn from observing what is actually practiced, and will assume that is the standard of care.......case in point being the mastectomy patient in another thread, where someone trained in that environment may assume that the standard of care is radical surgery, when worldwide, the best practice treatment is minimal surgery with chemotherapy/radiotherapy.....

2. in general, the level of healthcare in china is low, but like all developing countries, the quality varies very widely throughout the vast country.....so you do get very good high quality healthcare in major cities, especially those catering to expatriates......this is further compounded by very important ethical issues in many chinese practices, eg transplants for foreigners using executed prisoners, 'money medicine' where no treatment is forthcoming until the doctors are given angpows........

3.china's heathcare system also suffers from a bit of schizophrenia.......between modern scientific evidence based medicine, and traditional non-evidence based practices........the two exist side by side in most chinese hospitals (something like tung shin in kl)........and many doctors dabble in both.....this association between modern and alternative medicine raised ethical issues, and runs contrary to an important international ethical rule (msia included, one can get de-registered for doing so) of NOT associating with NON- medical trained people.......

4. this also spawn some very odd concepts and ideas, which is obvious in med students and graduates from there (personal experience with medical students attachments).......

5. msia does not recognise any chinese qualifications

6. spore does some of them, as is listed above.....

7. one should be careful with the chinese unis/schools, as those very similar named ones may not be the same........so make sure you are talking about the EXACT same med schools recognised by smc........

8. taking Zhejiang University School of Medicine as an example, they are selling ENGLISH based med education, based on 'medical council of india syllabus' ( i am not aware regulatory bodies like mci runs syllabus).......this is OBVIOUSLY a money making exercise to attract english speaking foreigners to study with them........NO native chinese can attend, as they know almost zero english........

9. therefore, it is likely the syllabus and training received in this english medium course will be different from the original native mandarin based ones.......this is important.......what exactly is smc recognising?.........the original degree, or this english medium one.......or both?

10. the lack of english speaking doctors in china will compromise the effective teachings.......they may possibly import lecturers, like ipts here does.......

11. i can find no information about what they consider minimum standards for entry........they just want 12 years of education with science subjects.......so i can't judge the quality they are like to be, which is often reflected in the admission policy........

12. international uni ranking means little in this case, you have to understand how the rankings are done first.......eg, some are based on the number of research done, which have little bearing on the quality of undergraduate studies.........

12. therefore, my advise is caveat emptor........(let the buyer beware).....

12. in ibrahim's particular case, if it is really the degree smc recognises, at that price, and with easy entry conditions, by all means go for it.....just remember, you will need to learn some mandarin, as EVERYTHING else will be in mandarin, including communicating with patients.........

"lumpectomy + adjuvant radiotherapy", or more precisely breast conservation surgery provides the same survival as mastectomy, but with likelyhood of more events.......although these events (eg recurrent disease) does not impact of overall survival.........

this case mentioned was stated to have nodal disease, so adjuvant hormonal manipulation is definitely needed if receptors are positive, and if the nodal load is heavy, or there is distant disease, chemotherapy may also be required........but that's not my point.....which was that radical surgery confers no additional benefit......

please refer to this thread......that is what i was referring to.....not a theoretical patient.....

http://forum.lowyat.net/topic/971263/+20

i was referring to 'additional events', NOT 'adverse events'.........BCS is associated with a 10% local ipsilateral recurrance, compared to less than 3-5% for simple mastectomy.......

again, the issue here is NOT between mastectomy and BCS, but whether radical surgery still have a place at all in modern management of breast cancer.......

in any case, it is not a matter of viewpoint, these factual infomation is pretty much evidence supported and in the public domain for the last 10 years.......

This post has been edited by limeuu: Mar 24 2009, 07:41 PM

the simple point i was trying to make was in my comments about chinese medical schools, where i used this case as an example of how the usual standard of practice locally will determine the kind of training and knowledge the students get.......

you as one training in oz will of course know what the internationally accepted standard of care is, as you outlined above.......

but you made a general comment about the variable need for adjuvant treatment, and i just pointed out in the specifics of the example i used, that there is NO question that adjuvant treatment is needed.........

ie, you used general observations to comment on a specific case i was referring to.......quote: "So no, the best practice does not necessarily require any chemo/radiotherapy; it all depends on the case. "

and now aware of the specific case i am referring to, you corrected yourself quote: (sic) "She's like to have chemo and possibly other adjuvant therapy eg hormonal/immuno after the surgery, we don't know for sure but fingers crossed that she receives the most appropriate treatment."

current consensus guidelines would unequivocally recommend that node positive patients will benefit from additional adjuvant treatment.........